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Today marks the two-year anniversary of my prophylactic double mastectomy at 21 years old. Last year I had a lot to say about my one-year anniversary; this year, I’m going to let photos do the talking.

Let these photos–organized in chronological order starting with March 13, 2012 and ending with last night–serve as evidence that my life has been full, happy, and pretty much awesome since my mastectomy. If you’re considering a mastectomy or you’re in the middle of breast reconstruction right now, I hope these photos give you confidence and encouragement for your own journey.

Monday was my final final final *crossing my fingers* surgery. Going into it, I felt a little like Veruca Salt. “I want perfect boobs Dr. Festekjian and I want them NOW!” “Festekjian…how much do you want for the perfect boobs? Name your price!” (I guess the answer to that will be arriving after the insurance adjustment in a few weeks!)

But really though. I did feel a bit…oh what should I say…spoiled? After all, I emerged from November’s implant exchange surgery with a pretty decent rack. After the swelling went down and I let things settle in for a month or two, I realized they were a good size and shape. But they weren’t perfect. And perfect is what I wanted, because, well–why not? After all of this–a mastectomy and an infection and reconstruction and all of these surgeries in the name of not getting breast cancer–I might as well get exactly what I want.

The main problems were the unevenness in nipple height and the rippling on the right side. But even the week before the surgery, when I sent an updated photo to a blog follower, she said they looked great and she thought I had already had the surgery to adjust the nipple height! For a moment there I considered canceling the surgery because I didn’t want to push my luck.

But…obviously I didn’t cancel it, and I’m sure glad I didn’t.

Per my usual routine, I spent all of Sunday chugging water like a crazy person to prepare my tiny veins to be poked and prodded. My mom picked me up from my apartment at 6:00 am on Monday morning. Jeani, bless her heart, had scheduled me for the earliest appointment because of the snafu that happened last time.

I checked in at the outpatient surgery center, changed into the sexy hospital gown and matching accessories, then chatted with a nurse. It’s kind of strange when you start to recognize the doctors and nurses…I’m pretty sure this particular nurse, who has been a vegan for over twenty years and always eats salad for lunch, has checked me in three times.

The most miraculous thing happened next. Brace yourself, because what you are about to read may rock your world and make you question everything you know.

A nurse anesthetist came in to talk to me about the anesthesia cocktail and start my IV. She was young, kind…unassuming. Little did I know of the POWERS SHE POSSESSED.

As is custom, my mom and I launched into our tirade about my horrible veins and the atrocities that have befallen me at the hands of IV nurses and anesthesia doctors alike in the walls of the UCLA Medical Center: the constant pokes, the unyielding veins, the need to “call in the big guns” and of course, the multiple PICC lines.

UNSCATHED by these warnings, the young nurse did persist with a smile. “I’ll have to numb you up then!” Haha, you fool! Numbing medicine will do nothing but make my uncooperative veins further retreat into the depths of my wrist/hand/arm/foot/every other part of my body, I mused as she left the room.

Moments later she returned carrying a tiny needle and an IV kit. As she stationed herself to my left, the noble Dr. Festekjian appeared, clad in a red track jacket. As we exchanged the standard hellos, the young nurse poked me with the numbing needle, warning me of a slight sting. “‘Twas nothing”, I murmured.

Then she started the long, daunting process of stabbing me with the IV needle to find a vein. I settled in for the long haul, turning my attention to Dr. Festekjian, when suddenly…within seconds…the voice of an angel rang out.

“All done! Your IV is started.”

A MIRACLE. It took her only ONE TRY, only ONE MEASLY POKE, to start my IV. I wanted to hug her, become her best friend, then follow her around from place to place for the rest of my life so she can always be the one to start my IV.

I was giddy with excitement at this point, but tried to remain steady while Dr. Festekjian played Connect the Dots on my chest with the pretty sterile pen. I figured that if I moved too much and the lines were uneven, it would be my own damn fault if my nips still looked lopsided.

A few minutes later the happy drugs were put into my IV, I was wheeled into the operating room, and then I was out. By 10 am I was awake in the recovery room, and I was discharged by 10:30 am.

Wisely, Dr. Festekjian warned my mom that I would be very bruised and very swollen for a while, possibly with some dimpling. I’m sure he was hoping to avoid the “WTF!” email he received last time. Even with the painkillers, I could definitely feel a dull soreness on my right side where he did all of the work. Even the arm fat near my armpit was super bruised.

I stayed home from work yesterday and today and took a shower this morning. I’m on antibiotics for a few days, and I’m definitely swollen; my right breast looks about one cup size bigger than the left breast, like I have a 1000 cc implant in there instead of 800 cc. And there is certainly some dimpling, mainly where the stitches are holding the skin up. But the nipples sure seem even and the alloderm seems to have gotten rid of the rippling, so I can’t wait to see how they look in a week or two!

My post-op with Dr. Festekjian is on Tuesday morning. I feel okay right now, still a bit sore, but I’ll be returning to work tomorrow. I did go on an hour-long walk this evening to stretch my legs, and that felt great. Hopefully I’ll get permission to head back to the gym next week. Interestingly enough, I am using my pit pillow again. It works well to support my arm when I’m on my computer and when I’m sleeping. Thanks again to my friend Kim who originally introduced me and my mom to pit pillows!

Pictures soon. Right now I’ve got them tucked up nicely in a sports bra so I don’t really feel like digging them out of there.

Instead, I leave you with a photo of the Chester Bug, keeping me company while I worked from home today. Isn’t he just the cutest little kitten? (Yes. I’m that person now. #instacat #catstagram #ilovemycat.)

First off, I want to thank all of my readers for supporting Young Previvors after our Facebook trouble a few weeks ago. Our original group has not been restored yet, nor have we heard anything from Facebook about why the group was deleted. We have, however, started a new Young Previvors group. Our admin, Liz, continues to do a phenomenal job of screening all potential new members, so if you are a previvor or a high-risk young woman, consider joining us. You can email me or search for “Young Previvors” on Facebook.

Things have been uneventful in my world of breast reconstruction, but they’ll pick up a bit in a few weeks. My final-final-final-last-one-I-seriously-promise-you’ll-never-have-to-read-about-it-again-unless-it-looks-ugly surgery is on Monday, February 25. Dr. Festekjian will be doing some minor cosmetic adjustments.

When I saw Dr. Festekjian at my two-month post-op a few weeks ago, I was still concerned about the difference in height between my nipples. Although they’ve certainly improved since my initial implant exchange surgery, the right nipple is still noticeably lower than the left.

At the appointment, Dr. Festekjian asked me point-blank which side I like more. I told him the left side, and to my relief, that was the acceptable answer. He can make my right side match my left side, but because of the extensive work he did on my left side during the implant exchange surgery, he can’t make the left side match the right. Unless, he joked, I get an infection on the right breast. Har har har. Funny.

In the outpatient surgery, he will lift up the right nipple and put some internal stitches in place so it sits higher. He will also add a layer of alloderm underneath my skin, to cover up the rippling. I plan to take a few days off work, but given my quick recovery from the past surgeries, I expect to be back in the office by Thursday. Watch…now that I’ve said that, I’ll have some horrible allergic reaction to the ice cubes in the recovery room and be bed-stricken for the next two months.

Okay, moving on: I have some very important and exciting news to share with everyone. I’d like to introduce you to Chester Frito Horn, my new furry child.

He’s an 18-week-old American medium hair. I officially adopted him from the animal shelter at 11:30 am on Saturday morning, then promptly sent him across the street to the vet surgery center to have his balls removed. Sorry, bug…YOU’RE IN MY WORLD NOW.

I picked him up this afternoon and he seems to be doing just fine. Here he is, Cone of Shame and all. He is now, in my parents’ words, a consultant.

Cat people: how can I get him to stay off of the kitchen counter? I’m scared he’s going to set his tail on fire with the pilot lights on the stove!

It’s been ten days since my implant exchange surgery. I admit that I originally planned to post about it much sooner, but emotions took me by surprise and I decided to wait a bit longer. Details about that to come later in this post.

My implant exchange surgery was at the UCLA Outpatient Surgery Center. I was told to arrive between 9:30 and 10 in the morning. I got there on time and completed the necessary paperwork after changing into the lovely surgery garb. Then I waited. And waited. And waited. By 11:45 am, Mom and I were rather annoyed. We were told that Dr. Festekjian was still in surgery from an earlier case.

It’s frustrating…but there’s nothing you can really do in that situation. If some sort of complication happened during my surgery, I’d want Dr. Festekjian to care about fixing it instead of trying to rush so he could get to his next case.

Finally Dr. Festekjian came by around 12:30 pm and drew all over me in marker. My chest looked like a game of Connect the Dots. Then the anesthesiologist stopped in to ask me a few questions and to start my IV. If you’ve been following my blog, you know about the IV drama. Well, the saga continued with this most recent surgery:

I mentioned to the anesthesiologist that I have very bad veins. After much prodding and examining, he informed me that “whoever said you had bad veins was wrong; you have NO veins.”

Well, shit.

He first tried my left hand. The needle went in and he poked around for a while but couldn’t get into a good vein. Ouch. Then he got wise and gave me a numbing shot, got down on his knees and poked my left wrist. After a few minutes he struck gold. Rejoice! No more poking. After he finished, he remarked that I could now put it on my CV that I “bring doctors to their knees.”

My veins really piss me off. Let me just rant for a minute: WHY ARE THEY SO AWFUL?! The day before my surgery I drank more than 80 ounces of water just to plump them up. And it was all for naught, because I still had to get stabbed multiple times! BLEHHHHH.

After the IV fun, I was wheeled into the operating room. That’s always a strange experience, because the anesthesia sleepy medicine has just been administered so I start to feel a bit giddy but I’m still coherent. Also, the operating rooms are never what I expect them to look like. I guess I’ve seen too many dramatic operating room scenes on TV.

Well I guess I conked out, because a while later I woke up in a recovery room to the sight of my friend Dustin, a first year UCLA medical student. Dustin and I went to high school together. He stayed with me for about 45 minutes, which was nice because it forced me to stay awake and to come out of my loopy state.

I was discharged around 4 pm and at my parents’ place in Redondo Beach by 5:30 pm. Bryce had a nice cold Jamba Juice waiting for me, and my mom whipped up some tomato soup. Yum. (I could really go for that right now, actually…)

All in all, the surgery process and immediate recovery was very reasonable. I did not take any narcotic pain meds (Tylenol was fine), and I could move around the house with relative ease.

Wednesday morning was the “big reveal,” the first time I would see my implants after surgery. I woke up early, excited to see them. I stood in front of the bathroom mirror, eyes closed, while Mom helped me cut off the ace bandage bra. The bandages were removed…I opened my eyes…and…

bleh. Bleh bleh bleh. I was not happy. My new breasts looked completely uneven. The left side was small and tight, while the right side seemed large and droopy. The nipples were no where near even. North and South Pole!

I stared for a while and then started to get emotional. Mom snapped some pictures and fired off a distraught email to Dr. Festekjian. I texted Bryce a very cryptic “my boobs look bad I’m sad leave me alone” kind of text, posted a quick “OMG” message to the Facebook previvor group, then cried myself back to sleep.

A few hours later I woke up to a reply from Dr. Festekjian and a bunch of comforting messages on Facebook. Apparently I was the only person in the world who did not know that you cannot judge the implants’ appearance immediately following surgery. Things are swollen, bruised, tight, uneven. They need to settle, and that takes time–weeks to months, even.

In addition to his email reply, Dr. Festekjian called later that day. He explained in detail that my left side had more scar tissue from the infection, so he did much more work on that side. Over time that side will drop and adjust to match the right side.

Well…that makes sense. The more he explained, the more I understood. He said he was still very happy with the results and could see symmetry in the breast folds. I don’t particularly know what that means, but a happy Dr. Festekjian is never a bad thing.

The reason I didn’t post on my blog that day or even the day after is that I didn’t want to be too emotional and scary. Emotion is good–and it’s honest–but I didn’t want my uneducated, post-surgery freakout to worry someone else who might be having the surgery. I hope that makes sense.

Yesterday I had a post-op appointment with Dr. Festekjian. Already he can tell that the left side is settling more. He said I should give it about eight weeks to relax into place, and that my right side will not drop anymore. We discussed options for after that eight weeks is up, incase I’m still not happy with the results. Fat grafting could be done to fill out “bumpy” areas (such as underneath the breast) and nipple alignment could also be adjusted. Insurance will cover those procedures since they are still a part of breast reconstruction.

I’m very pleased to know that I have options in the near future if I’m still not happy. But for now I’ll try to give it a rest and let nature take its course. Dr. Festekjian advised me to “stop thinking about your breasts for a little while.” I’m not so sure I’ll ever be able to do that, but I’ll try.

For now I leave you with these two comparison shots of the tissue expanders and implants. The implant shots were taken this evening. Also, if you are interested in seeing a comparison shot without the sports bra, send an email to rachel@tickingtimebombsblog.com. If I determine that you are not a creepy spammer/stalker, I will send you the pic.

I’m the worst blogger, I know. I’m sorry. I moved into my new apartment in September and I still don’t have Internet, but I don’t want to get it until I get a TV, which should be around November 10. For now, I have to mooch teh Interwebz off of work and my friends. But it is really awkward to post a new blog entry at work, when all of my blog posts have pictures of my boobs. It just doesn’t seem like the best idea, you know?

Let me update you on my breast reconstruction status: I had my final tissue expander fill with Dr. Festekjian on October 4. He filled each expander up to 700 ccs of saline. My expanders can hold up to 750 ccs, but Dr. Festekjian discouraged me from filling anymore. He said that the expanders already felt very firm and that the skin was tight, so more saline could be painful for me.

Stopping at 700 ccs was fine with me; I’m (at last) happy with the projection of my tissue expanders. You can’t see much of a difference between 650 ccs and 700 ccs, but here’s a comparison:

My implant exchange surgery is set for Monday, November 19, which is the Monday before Thanksgiving. I’ll be taking Monday, Tuesday, and Wednesday off work, then Thursday and Friday are vacation days. I should be back to work the following Monday.

Here’s me and my 700 ccs of saline on each side!

Last Wednesday was Breast Reconstruction Awareness (BRA) Day at UCLA Medical Center. I went with my mom and Bryce to show some love for Dr. Festekjian. I’m actually really glad we went; I didn’t think I’d learn much, but I asked Dr. Da Lio (another plastic surgeon) about the differences between silicone implants and “gummy bear” implants.

I’ve been hearing a lot about gummy bear implants lately, and I wanted to know what was so great about them. Dr. Da Lio told me that UCLA does offer gummy bear implants (a form of very dense silicone implants), but they are not yet approved by the FDA so patients who opt for them must participate in a study. He said they’re firmer than silicone implants and that they retain their shape when cut. But the negative is that they are not a perfect circle (unlike other implants); if they flip around under the muscle, the breast shape will change. They are not guaranteed to flip, but Dr. Da Lio said that upper body exercise could make it happen. I like to kayak and I want to get into weight lifting, so the risk of gummy bears flipping is there for me. Silicone implants it is!

I’ll be going in for a pre-op appointment with Dr. Festekjian on November 8. I already know that he is going to order a few different sizes of silicone implants for me, but hopefully he’ll give me some idea of the actual numbers and sizes.

Once my implant exchange surgery is done, I should be finished with surgeries. Since I had a nipple-sparing mastectomy, I don’t need to worry about nipple tattoos. But when I was at BRA Day, I met a tattoo artist named Ruth Swissa who does medical tattoos for breast reconstruction patients. Her work was AMAZING! She had a bunch of temporary 3D nipple tattoos. They looked SO REAL. She had one on her arm and if I didn’t know anything about mastectomies or breast reconstruction, I would have been really freaked out by it because it really did look like she had an oddly-placed nipple! To any of my readers who are going to have nipple reconstruction: email me if you want a few of the nipple tattoos! I snagged some and would gladly mail a few to you.

OK, I’ve been mooching off of my friend’s Internet for too long. Happy Halloween, everyone! I leave you with this picture from Saturday evening of Bryce and me. Can you guess who we are?

Is it really Sunday evening already? Where did the weekend go?! (Note: It’s now Monday and I am posting this while at work since I don’t have access to the Interwebz at home!) Well, now’s the time for reflection…starting with last weekend!

Last Sunday I attended a FORCE meeting in Agoura Hills. FORCE (Facing Our Risk of Cancer Empowered) is an organization focused on hereditary breast and ovarian cancer. There are chapters all over the country, including a few in Southern California. Until last week, I’d never attended a FORCE meeting.

There were about twenty women present, as well as a few brave husbands. We spent some time mingling and getting to know one another. Trisha was there and since I felt like the awkward new kid, I stuck to her. But I did make some new BRCA friends, too! Finally the guest of honor arrived: Dr. Karam!

If you’ve started reading Ticking Time Bombs recently or you’re a veteran reader who hasn’t been taking copious notes on every post, you might need a quick lesson on Dr. Amer Karam. I always talk about Dr. Festekjian, my plastic surgeon, but he is only half of my mastectomy dream team (I bet you didn’t know there was such a thing!). Dr. Karam is the breast surgeon who performed the first part of my mastectomy in March, removing all of my breast tissue. His official title is gynecologic oncologist; he performed my mom’s oophorectomy in February. We Horns really do like to keep things in the family.

With Dr. Karam’s arrival, we started the actual meeting. First there was a round of introductions; most people shared their name, family history of cancer, BRCA status, and if they have had or are planning to have any surgeries. There were a fair number of women who had already undergone prophylactic mastectomies and oophorectomies, but there were also quite a few who were just beginning to consider surgery.

The Q&A with Dr. Karam was very random and tangential. It seemed that one person’s question would inspire a new question from someone else, and we sort of bounced around the room for a few hours going from question to question. To be honest, all of the talk about breast cancer bored me—it’s really not on my radar anymore since my mastectomy! But I did find the discussions about ovarian cancer and breast reconstruction very useful.

Dr. Karam is a fantastic resource and I think he helped a lot of women at the meeting. He knows how to explain complicated scientific concepts in much simpler, easy-to-follow ways. I felt very proud to tell people there that he was my breast surgeon! It was almost a sort of “hahaha my breast surgeon is better than yours neenerneenerneener sticking my tongue out at you” moment.

The best part of the FORCE meeting was the breast reconstruction “show and tell” at the end! I felt relieved that my tissue expanders looked similar to those of other women at the meeting. And I got to see someone’s “finished product” which made me even more excited for my implants—hers looked amazing! A few of the ladies who are considering prophylactic mastectomies were very impressed by what they saw…my tissue expanders included. I think it’s very helpful and reassuring to see that the final outcome of a horrendous surgery can look so fantastic.

On Wednesday morning I had a tissue expander fill with Dr. Festekjian. I’m now up to 650 ccs of saline on each side, and I can certainly feel more tightness. We talked about what I want in an implant. I am most concerned about projection. Dr. Festekjian mentioned that style number 45 gives the most projection, but those implants are more narrow so they usually look best on people with a small chest. He said the next best option is style number 20, which my mom has.

Just for reference, this is what a tissue expander looks like.

And this is what a silicone implant looks like.

I know for sure I will have one more tissue expander fill, putting me up to 700 ccs on each side. I could go up to 750 ccs, but I think that might be a bit too big for me. These tissue expanders are starting to get pretty bulky! Plus, I want to have the implant exchange surgery on November 19, so the final tissue expander fill needs to be six weeks before that date.

Dr. Festekjian said that he will order a few options for implants. During the actual surgery, he’ll “try them out” to determine which looks best. Gee, it sounds like we’re shopping for prom dresses!

First, a bit of background on the Pan-Mass Challenge: The Pan-Mass Challenge is a bike-a-thon held every summer in Massachusetts. 100% of the money raised by riders is donated to the Jimmy Fund, a cancer research and treatment center at the Dana-Farber Cancer Institute.

My sister Wendy has participated in the Pan-Mass Challenge for twelve years, raising over $127,000 for the Jimmy Fund. This year, my niece Nicole (age 14) and my nephew Matthew (age 16) are stepping up their game by organizing the first Pan-Mass Challenge Teen Mountain Bike Ride, for 13-18 year olds.

The Teen Mountain Bike Ride will be held on October 13 at 9 am in Westwood, Massachusetts. If you know of any teenagers in the Boston area who are in need of community service hours, please let them know about the ride. It sure beats picking up trash on the beach!

Needless to say, I’m very proud of Matthew and Nicole for taking the reins on this idea. The Pan-Mass Challenge is a well-respected event in New England, and there is a similar bike ride for younger kids. Matthew and Nicole saw the need for a ride aimed at teenagers, and they’re making it happen.

Matthew and Nicole, the founders of the PMC Teen Mountain Bike Ride. Just a side note: aren’t they ridiculously good looking?

They’ve always been very receptive and caring kids. This past April, when they came to visit for their spring break, Nicole pulled me aside and asked how my boobs were doing (her words, ha!) Okay, I know that’s not a huge deal, but she’s only 14. (Actually, she was still only 13 at the time!) I was so touched and impressed that she not only understood my choice to have a mastectomy, but that she wanted to check up on me. It’s not exactly a light topic for anyone, let alone a teenager.

Well, this is the longest I’ve gone without posting…I know I know, I’m a bad blogger! But better late than never.

Now, I know you’re all dying to hear about my trip to Vegas. I’d like to tell you about how awesome it was and how much richer it made me, but sadly I cannot report those glorious things…because I didn’t go! Whomp whomp…

On Friday afternoon (August 24) I left work early for my scheduled fill with Maria, Dr. Festekjian’s wonderful nurse. I was supposed to go straight from UCLA to Long Beach where I would meet my friends and we’d hit the road to Las Vegas. But at the appointment, Maria noticed a slightly red spot on my left breast.

DUN DUN DUNNNNN (onomatopoeia anyone?). Red spots are not good, especially not for Her Royal Majesty the Queen of Cellulitis. I was pretty peeved because that spot had NOT been there in the morning.

Maria of course did the right thing by exercising caution, and in retrospect I’m glad she did—but believe me, in that moment I was not too pleased. I mean, come on…say it with me now…REALLY?! SERIOUSLY?! A RED SPOT…AGAIN?! #$*)(#@*$R JFAJFDSAF*#!)$#!

She decided to call Dr. Festekjian and consult with him. Well it just so happens that the good man himself was already stopping by UCLA (he spent the day working at the VA) so he came in to investigate. He poked and prodded for a while before determining that “he was not impressed.”

HOWEVER…given my history of infection, Dr. Festekjian decided to put me on antibiotics. He also advised that I avoid submerging myself in water (read: no swimming) and that I avoid sweating excessively (read: no 100 degree heat). Well, damn. Vegas in the summer without drinking, swimming and sweating just didn’t sound like very much fun.

Neither Dr. Festekjian nor Maria suggested I cancel my trip, but Dr. Festekjian did say that if the red spot worsened, I would need to come back in and possibly start IV antibiotics. BLEH! The thought of driving all the way to Vegas just to turn around and drive all the way back to Los Angeles was not very appealing.

I consulted my friends about it and they all agreed that it was not worth risking my health just for one weekend. We were able to reschedule the trip, and my friends still had fun doing touristy things around LA (they’re from Northern California). Side note: As much as it upset me to not be able to go to Vegas, I was still very touched by my friends’ response to the sudden change in plans. They were all so understanding and flexible, and even served as a sort of voice of reason for me when I was trying to figure out how to handle the situation.

Even though we didn’t make it to Vegas, we still had a fun weekend. Thanks Kim, Jo and Jill!

OK, so fast forward to this past Thursday. I went to UCLA to see Dr. Festekjian, and he confirmed that the red spot was gone and that we could proceed with my tissue expander fills. I am pretty sure the red spot was probably not an infection; if anything, I think I just slept on my tissue expander wrong and the pressure created that discoloration. But I am happy that we did not just dismiss it. I’ve come too far on this road to let it get screwed up, so being cautious is necessary.

Since Dr. Festekjian and Maria decided against giving me a fill that previous Friday, I was behind 50 ccs. I did manage to talk Dr. Festekjian into giving me 75 ccs during Thursday’s appointment. So now I’m at 400 ccs on the left and 550 ccs on the right. We’re catching up, baby!

My next tissue expander fill is on Friday afternoon, and after that I’ll be…wait for it…MOVING INTO MY NEW APARTMENT!

Yep, that’s right. I’m saying GOODBYE to my parents’ place in Redondo Beach and moving out into the real world! I managed to find a relatively-inexpensive (by LA standards) apartment a few miles from my office. The biggest perk will definitely be skipping out on all of the traffic I’ve come to love loathe.

But I will miss my puppy Madeline and my mommy packing me lunch. =( Give it two weeks and I’ll be begging my parents to take me back!

I love Hendrix. Also, that is Bryce’s hand, not mine. I do not have man thumbs.

I hope everyone had a great Labor Day. Bryce, Hendrix, and I spent the weekend up in Yosemite. I’m happy to report that I went kayaking on the lake twice and I even worked on my shot at the archery range. It’s been about ten years since I last touched an archery bow so I’m a wee bit rusty, but I’ll be back to my Katniss status in no time.

The kayaking and archery did make me think a lot about my upper body strength. When all of my surgeries are over (hopefully November) I think my next “project” will be getting some freakin’ muscle. I am such a weakling! Does anyone have any suggestions for upper body workouts? And keep in mind that I have a very short attention span when it comes to exercise. Fun and shiny=good!

Oh you know, just training for the Hundred Years’ War. BATTLE OF AGINCOURT, YEAH! [/nerd]

It’s been one week since my tissue expander placement surgery, and I feel great! I went back to work today and spent a long day (9 am-7 pm) in the office, sans pain medicine.

I’ll recap what last week was like:

After my parents and Trisha left on Monday, I did a bit of reading and then decided to go to bed. Sleep, however, did not come very smoothly. The pain pump that had earlier been my best friend turned against me by making me itch. It wasn’t the same awful head itching I felt when my Vancomycin IV started in April. It was more of a general body itching, but enough to wake me up every twenty minutes or so.

The nurse gave me Benadryl but that didn’t seem to help, so around 3 am we made the decision to switch from my pain pump meds (not sure what these were) to the painkiller Percocet. I was finally able to fall asleep for a few hours around 4 am.

By 6:30 am, Mom was in my room. Unlike at Ronald Reagan Hospital where discharge is 11 am, the Outpatient Surgery Center discharge for the special overnighters like me is very early (at 6:37 am! That’s a joke for Mom). And sure enough, Dr. Festekjian was in the room by 7 am, ready to kick me out.

He gave me instructions for the week, such as when to take my antibiotics and when I was okay to shower. He also cut off my stylish ace bandage bandeau bra and took out my PICC line. And he even agreed to pose for a photo, since he’s a blog celebrity and all.

Even early in the morning, Dr. Festekjian looks dapper…unlike me.

I spent most of Tuesday sleeping since I got little sleep the night before. Bryce did come over and we lounged around watching movies. On Wednesday evening my friend Kim visited after she got off work. We had dinner and went on a walk. I started switching from Percocet to regular Tylenol on Wednesday.

On Thursday I worked from home. Luckily my manager Jerri is very understanding of this strange and often complicated medical situation, so she helped me create a work project that would be doable from home: scrapbooking.

That’s right, I was paid to scrapbook. I work as an Associate Editor at eHow.com, and one of our new products is called Spark. It’s sort of like a bulletin board for the web; you can clip photos and text from around the Internet onto one space. My Spark boards give instructions for creating scrapbook pages in a more visual format. You can see one I finished, How to Create Graduation Scrapbook Pages.

I also took a shower on Thursday. Aw, the first shower after surgery—pure bliss. I could have showered on Wednesday, but my PICC line bruise made me nervous, so I waited an extra day to be safe.

The bruise is horrendous. It looks like I was punched in the arm by someone very large and very angry. When I had a PICC line on my right arm in April, the bruising was minimal. When I first took a good look at this bruise, it really did freak me out. But I consulted Drs. Horn and Horn and they assured me that it was perfectly normal. And sure enough, the bruise has gone down.

Yes, I took that picture today, and yes, it does still look awful after a week. But you should see the other guy!

On Friday morning, Mom and I hopped in the car and drove up to Los Angeles to the Playboy Mansion to pick up Trisha to go shopping. This, however, was no ordinary shopping trip: we were in search of mastectomy bras and cotton breast forms! After giving Mom a quick tour of the Mansion, we headed to Miss Stevens, a lingerie store.

Mom was definitely a fan of Mr. Hefner’s digs.

Miss Stevens is a store known for its wide array of undergarments to fit unusual sizes and needs. My mom bought her mastectomy bras there and the one that I eventually wore, so no doubt the ladies there are well-versed in mastectomies. However it still felt surreal for Trisha and I to walk in–two young girls in their twenties–and ask for mastectomy bras and breast forms.

The lady at the counter did not miss a beat, and immediately shooed me to a fitting room. I further explained my situation to her, and finally unbuttoned my shirt to show the differences in size. The exact current measurements are 250 ccs of saline in the left tissue expander, 550 ccs of saline in the right tissue expander.

She presented me with various options, ranging from adjustable silicone forms to small bra cup inserts. The silicone forms are always nice, but man! were they expensive. The one she showed me was at least $250! I love myself and I want to look my best, but I am not going to spend that much money just to be even-chested for a month.

I opted for two cup-like inserts. Layered one on top of the other, they give enough shape to match the 550 ccs on the right. Once I am filled up a bit more, I will only need one of the inserts. And then soon (hopefully by mid September) I’ll be even on both sides!

The inserts ended up totaling only $12; pretty good compared to the silicone option. Trisha graciously paid for my inserts as a “thank you” for taking her shopping. Her search for a mastectomy bra was a bit more difficult.

Since she has such a small frame, even the smallest sizes of the mastectomy bras would end up being too big for her after her mastectomy. Sure she could pin them to keep them tight, but that would require constant adjusting…not fun or practical!

After much debate, she ended up buying a mastectomy bra that also works as a compression bra. I think it’s Amoena #2161. My mom used the same kind after her implant exchange surgery, and I have used it too, though it can be a bit itchy so I prefer my softer mastectomy bra. But it opens in front and the stretchy fabric will stay tight on Trisha; plus it has Velcro at the bottom for drain pockets to attach.

Of course it doesn’t actually come with drain pockets, which is so bizarre to me. Drain pockets are probably the cheapest thing to manufacture; they are just little scraps of fabric with Velcro on one side! But for whatever reason, many mastectomy bras don’t actually come with them. Luckily my mother the seamstress has some ideas in mind for Trisha’s drain pockets!

On Saturday morning I drove for the first time, up to the bagel store. Later in the evening I drove all the way to Bryce’s house, which is about an hour away. I definitely favor my right side when I drive so I didn’t feel much strain.

The pain meds finally caught up to me yesterday morning. I’d been mostly taking Tylenol for pain, but sometimes at night I did take a Percocet. I ended up having a splitting headache that started around 10:30 am. I rarely get headaches that are more than just a dull pain, so this one really took me by surprise. I called Mom, almost in tears, and she told me to try to sleep it off in a dark room with a cold compress on my head. The headache was gone by 1 pm (thanks Mom!) and I am officially OFF of Percocet because that was just too painful.

It’s funny how pain medication can sometimes cause more problems than the actual pain is worth.

Today I scheduled my post-op appointment with Dr. Festekjian. I’ll be seeing him on Thursday at 3:45 pm. Hopefully he’ll give me the all-clear to start my tissue expander fills the following week!

I leave you with this picture of me this evening with the two cup inserts in: WHICH SIDE IS SMALLER THAN THE OTHER?! It’s an optical illusion oooooooohhhhoooooh! (OK cut the crap, Rachel.)

Well, it’s official: I am back on track with my breast reconstruction! My left tissue expander was placed this morning.

I spent all day yesterday chugging water; I must have consumed two gallons! I hate not being able to eat or drink after midnight the night before surgery. Since I was scheduled to receive a PICC line, I knew that drinking all of that water would make no difference for my veins. It’s just a mental thing.

But sure enough, as soon as I woke up this morning, I was thirsty. My mouth felt like the freakin’ Sahara today! Just knowing I can’t drink water makes my body trick me. Argh!

I arrived at UCLA around 7:30 am and had my PICC line placed at the radiology area of Ronald Reagan Hospital. The nurse who put in the PICC, Jessica, was very sweet and approachable. We talked the whole time she was working on my left arm, making it go by quickly. The pain was minimal, just a bit of a pinch from shots of numbing medication.

After she placed the PICC line, Jessica walked me back to the check-in area and told me what I couldn’t do with the PICC line in. The best “no-no” was scuba diving…she actually told me I couldn’t scuba dive. I laughed it off, but she said that she once had a patient go scuba diving with a PICC and it got infected. I mean, really? Come on! How thick can you get?

Needless to say, I have NO plans to scuba dive.

Mom and I walked from Ronald Reagan Hospital to the 200 building and headed up to the Outpatient Surgery Center around 8:50 am. I’m quite familiar with that area since Mom had her oopherectomy and implant-exchange surgery there in February. I checked in and was brought back to the pre-op area almost immediately.

I spent the next hour sitting in bed with my attractive blue hospital gown and hair net as nurses and doctors bombarded me with questions. “Do you have any allergies?” Sulfa. “When was your last surgery?” April 30. “Did you get a PICC line?” Yes, notice the strange tube coming out of my arm.

Finally, my best friend, the man of the hour, the genius himself Dr. Festekjian came to see me. He marked up my chest like a ninth-grader graphing in Geometry class. Symmetry is good, so he wanted to give himself the best markers for placing the tissue expander! Hey, it works for me. He’s the artist and I trust his judgment!

Next I was given some calming medication through the PICC line, and then I was wheeled back into the operating room. Things get blurry from there, but I do remember thinking that the OR was very cluttered and bright. Doctors and nurses were all around me, covering me in blankets and poking me with monitors…

And then I woke up!

That’s one happy camper! Notice my stylish bra.

I think I was out for about an hour and a half. Since my procedure was outpatient, they did not give me a pain pump. BADDDDD idea. Of my now three surgeries (initial mastectomy, tissue expander removal, and today’s tissue expander placement) this was by far the most painful! My entire left side felt very heavy and there was a lot pressure. The nurses kept giving me pain meds through the PICC line, but I was not having it.

Finally, Mom took action. “How long does she have to be a 10 out of 10 on the pain scale before she can get an order for a pain pump?” You go, Mom! As soon as she asked that, Dr. Festekjian was paged and a pain pump was installed.

Once I got the pain pump I felt infinitely better.

Dr. Festekjian has me on IV antibiotics for precautionary measures, so I’m staying overnight. My room is very small and has a stunning view of a parking lot. Unfortunately there is no bathroom in my room (unlike the rooms in the actual hospital) so I have to walk into the hall to use the bathroom, but that’s okay because I want to be as mobile as possible. Lying in bed all day can get very boring and even a bit painful.

I’ll be discharged early tomorrow morning (by 7 am) and Dr. Festekjian will send me home on oral antibiotics. If all goes smoothly, he’ll start my tissue expander fills in two weeks. I think he filled me up to 200 ccs when he placed the expander, but I have to wear my lovely ace bandage bra for a while so I can’t really tell.

Trisha came to visit me around 6:30 pm. It was so nice to see her! She brought me beautiful purple flowers. Purple is my favorite color. We chatted for about half an hour and then my parents showed up with dinner for me, so we all sat around talking for a while.

Aren’t they beautiful? Thanks, Trisha!

Talking to Trisha was great because she understands what I’m going through. Her prophylactic mastectomy is scheduled for August 15, so it’s been on her mind a lot. I must brainstorm what I can give her for a pre-surgery care package!

I look like a giant compared to Trisha, she is so petite!

Trisha and my parents left about 45 minutes ago. I’m going to try to get some sleep now since I haven’t slept much today.

Thank you all for all of your support. I really appreciate the suggestions you left on my last post for evening out my tissue expanders–I’m definitely going to try some of them out!

This coming Monday, July 30, I’ll be making the trek back up to what seems like my home away from home, UCLA Medical Center. At 8 am I am scheduled to have a PICC line placed at Ronald Reagan hospital; following the PICC line procedure, I’ll head over to the UCLA Outpatient Surgery Center in the building next door to have my tissue expander placed.

It was a bit of a hassle to get approval for the PICC line, but I’m so glad we were pushy (shout out to my mom for making it happen!) For those of you who don’t remember, I have BAD veins. They run and hide when I get within five miles of a medical facility.

When I know I am going to have my blood drawn, I prepare the day before by drinking a lot of water to pump up my veins. When I was admitted to the hospital for a cellulitis infection in late April, my veins were not prepared for needles and I was already dehydrated from being sick. When the nurses tried to draw blood, it took them three pokes (with multiple people involved) until they had success; when they tried to start IV antibiotics, it was even worse.

I ended up being poked for blood and IVs about ten times during that hospital stay because my veins would either not produce any blood or they were too fragile for the strong antibiotics. By the third day at the hospital, none of my veins were strong enough for a simple IV, so I was switched to the PICC line.

The PICC line was my savior. I never thought I would love something attached to a needle as much as I loved that PICC line.

“PICC” stands for peripherally inserted central catheter. It is a small needle attached to a port that is inserted into a deep vein (in my case, in my upper right arm). It’s then fished through to another vein close to the heart. A PICC line can stay in place for weeks without being changed, and it can be used to draw blood and to administer fluids such as antibiotics. For those of you who know my family, when my dad was at UCSF in 2010/2011 with a foot infection, he received routine antibiotic infusions through a PICC line.

Once my PICC line was inserted in April, the rest of my hospital stay was a breeze. I didn’t feel any burning from the antibiotics and no one had to poke me in the middle of the night for blood tests.

This time around, my mom and I have been adamant that I receive a PICC line from the start. I know Dr. Festekjian is going to put me on IV antibiotics as a precaution, and I know I am going to be put under anesthesia. Both of those things mean needles. Any needle poke runs the risk of infection; with my non-compliant veins and history of infection, why would I want to take any chances? PICC line, here I come!

In terms of the actual tissue expander replacement surgery, I anticipate that it will be pretty easy. It’s performed in UCLA’s outpatient building, which already makes it seem more minor. There’s a good chance I will stay in the hospital overnight just to be safe, which is fine with me. And I only plan on taking one week off from work, as opposed to the three I took after my mastectomy surgery in March.

To be honest, the biggest concern I have is what I’ll look like with my newly-inserted tissue expander. I’ve really adjusted to having my cotton prosthesis and Waterproof Falsie; they are the perfect size to match the 550 cc tissue expander on the right side! But when Dr. Festekjian puts the new tissue expander in the left side, he will probably only fill it up to about 200 ccs; tiny in comparison to the other one!

Does anyone have any suggestions for what I can do to not look lopsided? There will probably be at least one month of unevenness; I don’t expect to start my saline fills until two weeks after this surgery. And even when the fills do start, it will take a few sessions before my left tissue expander is equal to my right expander.

Okay, nothing could be more lopsided than this: tissue expander on the right side, nothing but chest wall on the left!

I’d love to hear what people think. My initial thought is to use socks or something to fill empty bra space. Anyone else have a better idea?!

I expect to post an update on Monday or Tuesday following my surgery, so be on the lookout for that. And all positive vibes and thoughts are appreciated as I get ready for Monday! Thank you. =)

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Hi, I'm Rachel, your average twentysomething. I'm in a sorority, I just graduated from college and started my first full-time job, and oh yeah, I recently had a double mastectomy! Welcome to my world of BRCA genes, plastic surgery, and snap-in-front bras.

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